Hydatid liver cysts:: mid-term results of percutaneous image-guided sclerotherapy

Objective. To evaluate the mid-term efficacy of percutaneous image-guided treatment of hydatid liver cysts. Design. Twenty-five cysts in 21 patients were treated by percutaneous sclerotherapy in 30 sessions. The cytological and serological results were recorded. Alcohol (96%) or hypertonic (20%) saline was used as sclerosant agent. Twenty-gauge Chiba needles were used for all cysts except two infected cysts that underwent catheter drainage. Follow-up (range: 1-4 years) was obtained at regular intervals by ultrasound and computed tomography. Change in the cysts, volume was calculated. The procedures were regarded as successful if the decrease in volume was more than 70% together with disappearance or significant improvement of symptoms. Results. Seventeen cysts in 16 patients showed a volume reduction superior to 70% with symptoms diminishing or disappearing. Four cysts disappeared completely. Eight cysts in five patients did not respond to the treatment with little or no change in size and symptoms. The average decrease in volume for cysts was 63%. The procedure was regarded as successful in 76% of the patients. No major complications were noted during or after the procedures. Conclusion. Mid-term results of percutaneous image-guided treatment of hydatid liver cysts show that this method is relatively easy, safe and effective and should be considered before surgery.